Planned Evaluation of the Healthy Weight Clinic Pediatric Weight Management and Implementation: Massachusetts-CORD 3.0.
Lauren G FiechtnerDesiree Sierra VelezSujata G AyalaInes CastroJeanne LindrosMeghan PerkinsAlison BakerJeremiah SalmonVincent BiggsGerri Cannon-SmithJustin D SmithMeg SimioneSteven L GortmakerElsie M TaverasPublished in: Childhood obesity (Print) (2021)
Background: Despite evidence that offering multidisciplinary treatment for children with obesity is effective, access to evidence-based pediatric weight management interventions (PWMIs) is limited. The Healthy Weight Clinic PWMI is a multidisciplinary approach in primary care that improves BMI among children with a BMI ≥ 85th percentile. Objective: To describe the method by which we will evaluate the adoption, acceptability, and feasibility of integrating and implementing a multidisciplinary Healthy Weight Clinic (HWC) into primary care. Design/Methods: We used the Consolidated Framework for Implementation Research (CFIR) domains and constructs to inform our implementation strategies. We will use a Type III hybrid effectiveness-implementation design to test our implementation strategies and improvement in BMI. Sources of data collection will include qualitative interviews with patient caregivers, HWC staff and surveys with HWC staff, patient caregivers, and electronic health record data. Our outcomes are guided by the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Results: We identified all five CFIR domains as integral for successful implementation. Some strategies to address barriers within these domains include online self-paced training modules for the HWC staff, a virtual learning collaborative, and engagement of site leadership. Outcomes will be measured at the patient and pilot site levels, and they will include patients reached, patient health outcomes such as BMI and quality of life, level of adoption, acceptability, feasibility, and sustainability of the PWMI. Conclusion: Our use of implementation science frameworks in the planning of Healthy Weight Clinic PWMI could create a sustainable and effective program for dissemination.
Keyphrases
- primary care
- quality improvement
- body mass index
- electronic health record
- weight gain
- weight loss
- physical activity
- healthcare
- case report
- general practice
- systematic review
- randomized controlled trial
- palliative care
- young adults
- metabolic syndrome
- public health
- body weight
- machine learning
- clinical trial
- study protocol
- prognostic factors
- drinking water
- ejection fraction
- combination therapy
- network analysis
- adverse drug
- smoking cessation